Virchows Archiv

, Volume 464, Issue 2, pp 175–190 | Cite as

Consensus on the histopathological evaluation of liver biopsies from patients following allogeneic hematopoietic cell transplantation

  • Judith Stift
  • Hideo A. Baba
  • Elisabeth Huber
  • Birgit Federmann
  • Hans-Peter Fischer
  • Annette Schmitt-Graeff
  • Herrad Baurmann
  • Wolfgang Bethge
  • Peter Schirmacher
  • Fritz Wrba
  • Hildegard Greinix
  • Falko Fend
  • Rainer Schwerdtfeger
  • Howard M. Shulman
  • Daniel Wolff
  • Thomas LongerichEmail author
  • on behalf of the Liver Pathology Group of the German-Austrian-Swiss Working Group on GvHD
Original Article


After allogeneic hematopoietic cell transplantation (alloHCT) liver biopsy is performed for enigmatic liver disorders when noninvasive diagnostic steps have failed in establishing a definitive diagnosis. This document provides an updated consensus on the prerequisites for proper evaluation of liver biopsies in alloHCT patients and the histological diagnostic criteria for liver graft-versus-host disease (GvHD). The Working Group’s recommendations for the histological diagnosis of liver GvHD were derived from the peer-reviewed literature and from the consensus diagnosis of a total of 30 coded liver biopsies. Acceptance of the recommendations was tested by a survey distributed to all HCT centers in Austria, Germany and Switzerland. Consensus was achieved for biopsy indications, methods of sample acquisition and processing, reporting and interpretation of biopsy findings. As GvHD is variably treated and the treatment modalities have changed over time, the panel endorses the use of more frequent biopsies in clinical studies in order to improve the present challenging clinical and diagnostic situation.


Liver GvHD Biopsy Consensus 


Conflicts of interest

D.W. serves as consultant for Falk Pharma. The remaining authors declare that they have no conflict of interest.

Supplementary material

428_2013_1528_MOESM1_ESM.doc (39 kb)
ESM 1 (DOC 39 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Judith Stift
    • 1
  • Hideo A. Baba
    • 2
  • Elisabeth Huber
    • 3
  • Birgit Federmann
    • 4
  • Hans-Peter Fischer
    • 5
  • Annette Schmitt-Graeff
    • 6
  • Herrad Baurmann
    • 7
  • Wolfgang Bethge
    • 8
  • Peter Schirmacher
    • 9
  • Fritz Wrba
    • 1
  • Hildegard Greinix
    • 10
  • Falko Fend
    • 4
  • Rainer Schwerdtfeger
    • 7
  • Howard M. Shulman
    • 11
  • Daniel Wolff
    • 12
  • Thomas Longerich
    • 9
    Email author
  • on behalf of the Liver Pathology Group of the German-Austrian-Swiss Working Group on GvHD
  1. 1.Institute of Clinical PathologyMedical University of ViennaViennaAustria
  2. 2.Department of Pathology and NeuropathologyEssen University HospitalEssenGermany
  3. 3.Institute of PathologyUniversity of RegensburgRegensburgGermany
  4. 4.Institute of PathologyUniversity of TübingenTübingenGermany
  5. 5.Institute of PathologyUniversity of BonnBonnGermany
  6. 6.Institute of PathologyUniversity Medical Center FreiburgFreiburgGermany
  7. 7.German Clinic for DiagnosticBMT UnitWiesbadenGermany
  8. 8.Department of MedicineUniversity Hospital TübingenTübingenGermany
  9. 9.Institute of PathologyUniversity Hospital HeidelbergHeidelbergGermany
  10. 10.Department of Internal Medicine I, Bone Marrow TransplantationMedical University of ViennaViennaAustria
  11. 11.Fred Hutchinson Cancer Research CenterUniversity of Washington School of MedicineSeattleUSA
  12. 12.Department of Internal Medicine IIIUniversity of RegensburgRegensburgGermany

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